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2025 Exam Report Orthopedic Specialty Exam May2026 2of 6 BOC 2025Annual OSEReport Introduction The Board of Certification, Inc., (BOC) is a non-profit credentialing agency that provides certification for the athletic training profession. Incorporated in 1989, the BOCgovernsthe certification program forAthletic Trainers (AT)byestablishingboth the standards for the practice of athletic training and the continuing education requirements.The BOC serves the public interest by developing, administering and continually reviewing a certification process that reflects current standards of practice in athletic training. In 2021, the BOC launched theOrthopedic Specialty Certification (orthopedic specialty) for ATs. The Board CertifiedSpecialist in Orthopedics (BCS-O®) credential is available to ATs who have acquired specialized education and focused experience in orthopedics beyond the requirements for the ATC ® credential. It is the first and only board-certified specialty for ATs who specialize in orthopedics,and it is backed by the BOC’s rigorous process and standards. Standard Setting and Equating of Exam Forms The modified Angoff process was used to establish the performance standard for the Orthopedic Specialty Exam (OSE). In October 2021, a panel of eight certified ATs with a specialty practice in orthopedics participated in the study. All new forms will be equated to the passing standard established for Form PA101 using a method that is appropriate for small programs after the first exam window in which they are used. Score Reporting Raw scores for the OSE are reported as scaled scores. Scaled scores are particularly useful because they provide the basis for meaningful long-term comparisons of results across different forms of an exam.New forms are introduced to ensure that items are not overexposed for exam security purposes, to maintain relevance to the profession, and to keep up with any changes that may occur to the composition of the blueprint, exam length, or other assessment mechanism. These forms are built to the same content specificationsas the existing blueprint,but they are not necessarily constructed at thesame difficulty level. Equating is a statistical process that transformsnew form rawscoresonto the same scale as the original base form scoresto adjust for minor differences in difficulty across forms.The equated scores are then converted via linear transformation to a scale of 1000 to 1450,with the passing standard reported as 1200. The BOC provides scaled scores(for fail applicants)and pass/fail standing to applicants approximately two to four weeks after the close of anexam window. Applicants pass or fail based on how their exam performance compares to the criterion-referenced passing standard. Because the content areas specified for the exam were validated as critical for specialty practice, the items and the forms are intended to assess essential knowledge and/or skills for newly certified orthopedic specialists. Overall scores from the exam can be used to make inferences about the relevant knowledge and skillsthat applicants have acquired. Scores on the OSE are not, however, intended as predictors of future success in the specialty. 3 of 6 BOC 2025 Annual OSEReport Analysis of the OSE Applicant Performance Applicants may qualify to take the OSE by completing an accreditedresidency in orthopedics or by satisfying alternative eligibility criteria. Applicants taking the OSE in the period addressed in this report were classified as either first-time exams or retake exams: First-time exams: Exams taken by applicants who never previously sat for any form of the OSE Retake exams: Exams taken by applicants who previously sat one or more times for OSE This report includes 24 exam events of the OSE across two administration windows, a slight increasefrom the 2024 testing year (22). Of the 24 exam events, two (8.3%) were graduates of an athletic training residency in orthopedics and 22 (91.7%) qualified by meeting other requirements.Additionally, 20 (83.3%) of the exam events involved applicants taking the exam for the first time, while 4 (16.7%) were retake attempts, each involving a unique individual(see Table 2). Pass Rates Table 1 provides annual pass rates for the OSE since 2021by eligibility pathway; and Table 2 provides annual pass rate by Retake status. Table 1. Historical Counts and Pass Ratesfor the OSE Overall and by Eligibility Pathway Year Path 1 ResidencyPass% Pass Path 2 OtherPass% PassAllPass% Pass PA103 202155100.00%10440.00%15960.00% 20222150.00%15640.00%17741.17% 20235360.00%17847.06%221150.00% 2024 3 3 100.00%19 11 57.89%221463.64% 2025 2 1 50.00%22 16 72.73%241770.83% Table 2. Historical Counts and Pass Ratesfor the OSE Overall and by Retake Status YearFirst-timePass% PassRetakePass% PassAllPass% Pass PA103 202115960.00%---------15960.0% 202212541.67%5240.00%17741.2% 202315960.00%7228.57%221150.00% 2024 14 11 78.57% 83 37.50%221463.64% 2025 20 14 70.00% 43 75.00%241770.83% 4 of 6 BOC 2025 Annual OSEReport Table 3 presents pass/fail statistics for each form administered by modality during the 2025 exam year. The overall pass rate for 2025 was 70.83% Table 3. BOC OSE Exam Pass Rates by Form and Modality Form FrequencyPercent ModalityPassFailTotalPassFail PA103Onsite 9 5 1464.29% 35.71% LRP 821080.00%20.00% Total 1772470.83%29.17% All 1772470.83%29.17% Distribution of Candidate Scores Table 4 presents scaled score summary statistics for the 2025 annual testing cohort, alongside the previous years of testing. Table 4. Historical OSE Scaled Score Summary Statistics Grouped by Retake Status CohortNMeanMedianStd DevMinMax All 2025241220.0121557.810561326 First-time201221.0122163.010561326 Retake41215.0121219.911941242 All 2024221225.1121252.511581344 First-time141242.9124557.811581344 Retake 8 1194.0119418.111701224 All 2023221196.2120342.911221272 First-time151205.6121843.711341272 Retake 7 1176.0118235.711221212 All 2022171196.1118865.711101368 First-time121201.5118874.611101368 Retake51183.2117641.011341236 All 2021151233.2120097.311041410 First-time151233.2120097.311041410 Retake ------------5of 6 BOC 2025Annual OSEReport ExamForm Reliabilities and Other Summary Data The performance of the OSE form used during the year is consistent with reporting requirements for the National Commission for Certifying Agencies accreditation. Reliability is assessed using Cronbach’s alpha (Cronbach, 1951), the most widely used measure of overall exam form reliability; Livingston-Lewis (Livingston & Lewis, 1995), a measure used for estimating the decision consistency (i.e., the reliability of pass/fail decisions based on the test); and the standard error of measurement (SEM) presented in raw score units, a measure of the precision of the exam form. A new form was introduced in September 2024,and reliability and decision consistency estimates for the exam were in an acceptable range for 2025. Summary and Conclusions Statistics concerning the quality of the OSE as a measurement instrument indicate that the exam complies with psychometric requirements that pertain to certification and licensure exams. Collectively, reliability estimates were appropriate for the use of making pass/fail decisions for candidates. Moreover, items are consistently evaluated statistically, through independent SME review after each window, and aggregate review over previous administrations, to ensure the relevance and validity of all items. The BOC is committed to maintaining the integrity and fairness of its exam forms. 6of 6 BOC 2025Annual OSEReport References Brennan, R. L., & Kane, M. T. (1977). An index of dependability for mastery tests. Journal of Educational Measurement, 14, 277–289. Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16,297–334. Kuder, G. F., & Richardson, M. W. (1937). The theory of the estimation of test reliability. Psychometrika, 2, 151–160.Next >